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ADA develops guideline for evaluating potentially malignant disorders in the oral cavity

September 25, 2017

By Michelle Manchir

Dr. Lingen
All adult dental patients should receive an intraoral and extraoral conventional visual and tactile examination when visiting their dentists, according to ADA-developed recommendations published in the October issue of The Journal of the American Dental Association.

The clinical recommendation is one of six stated in the "Evidence-Based Clinical Practice Guideline for the Evaluation of Potentially Malignant Disorders in the Oral Cavity." The guideline offers clinicians an overview about the potential use of adjuncts as triage tools for the evaluation of lesions, including potentially malignant disorders, in the oral cavity.

Other key takeaways of the guideline, available to read online, include:

  • When examining their patients, dentists need to distinguish among mouths with no lesions, mouths with seemingly innocuous lesions, and mouths with lesions suspected to be potentially malignant or malignant and act accordingly.
  • For lesions suspected to be malignant, an immediate biopsy of the lesion or referral to a specialist is recommended.
  • The guideline does not recommend the use of salivary or light-based adjuncts for evaluating lesions for malignancy.

The guideline comes after an expert panel convened by the ADA Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review of the best available evidence. The article in the October issue of JADA includes an easy-to-follow summary of the guideline's recommendations in a pathway that depicts how dentists should proceed with each of the clinical scenarios mentioned in the first bullet point above. A Chairside Guide will also be available in JADA as an easy reference for clinicians, said Dr. Mark Lingen, Ph.D., chair of the guideline's expert panel and an oral and maxillofacial pathologist and professor of pathology at the University of Chicago Pritzker School of Medicine.

"This guideline is the result of a collaborative effort between ADA staff and experts in oral cancer for the expressed use and benefit of the ADA membership and, most importantly, the patients we are charged with caring for," said Dr. Lingen.

This guideline serves as an update of the ADA's 2010 recommendations on screening for oral squamous cell carcinomas.

The article laying out the guideline is the cover story of the October issue of JADA and is available online at

Dr. Lingen will present the guideline's recommendations during a talk, ADA Clinical Practice Guidelines on the Evaluation of Oral Cancer (6809), on the ADA Science Institute Stage at ADA 2017 – America's Dental Meeting at 8 a.m. on Friday, Oct. 20. For more information, visit